Adnexal masses: accuracy of characterization with transvaginal US and precontrast and postcontrast MR imaging.

Yamashita, Yasuyuki; Torashima, Miyuki; Hatanaka, Yoshimi; Harada, Mikihiko; Higashida, Yoshiharu; Takahashi, Mitsuru; Mizutani, Hirokazu; Tashiro, Hironori; Iwamasa, J; Miyazaki, Kohji

doi:10.1148/radiology.194.2.7824738

Cited by 146 publications

(87 citation statements)

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“…All endometriomas in this study had high signal intensity on T1-weighted images with loss of signal on T2-weighted images (''shading''), as already shown by previous studies (3,4,15). In this series, as in the study by TOGASHI et al (23), no case of malignancy was misdiagnosed as an endometrial cyst.…”

supporting

confidence: 84%

“…some authors (8,4,14), it was not included as such in our study, as we agree with others that lesion size (4 cm) when combined with other imaging findings does not further contribute to the prediction of malignancy (9). The bilaterality of adnexal lesions is another accepted criterion of malignancy.…”

mentioning

confidence: 57%

“…US and MRI are the most useful modalities for the assessment of adnexal lesions (4). US should be the primary imaging approach for the assessment and characterization of adnexal lesions (2).…”

Section: Discussionmentioning

confidence: 99%

“…However, magnetic resonance imaging (MRI) is superior in the characterization of adnexal masses (4) and should be used to further characterize indeterminate adnexal mass identified by US (5). Previous imaging studies have reported accuracies in the characterization of malignancy of adnexal masses ranging from 60 to 95% for US (4,6,7) and from 83 to 94% for MRI (3, 4, 7Á13); the lower figure of 83% is from a relatively early pioneer study using older equipment (3).…”

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confidence: 99%

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Magnetic resonance evaluation of adnexal masses

2008

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Background: Accurate evaluation of adnexal masses allows correct surgical procedure, avoiding unnecessary surgery. Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of malignancy of adnexal lesions. Material and Methods: We retrospectively reviewed the pelvic MRI scans of 161 patients with 199 surgically confirmed adnexal masses, between November 1998 and June 2005. The criteria for adnexal malignancy were contrast-enhanced solid lesions, contrast-enhanced solid components in mixed lesions (except those with low-signal-intensity solid components on T2-weighted imaging [T2WI]), contrast-enhanced papillary projections in cystic lesions (except those with low-signal-intensity papillary projections on T2WI), or septal thickness ≥3 mm. Ascites, peritoneal metastasis, and pelvic adenopathy were also regarded as criteria for malignancy. Results: On MRI evaluation, 97 adnexal lesions were malignant and 102 were non-malignant. Thirty-two percent of patients with ascites had benign lesions. Histopathologic evaluation of the adnexal lesions showed that 83 were malignant (true positives), 100 were non-malignant (true negatives), and seven were uncertain malignant potential tumors; two were false negative and seven were false positive. The MRI sensitivity and specificity for malignancy were 98% and 93%, respectively. MRI reached an accuracy of 95%, with a positive predictive value of 0.92 and a negative predictive value of 0.98 for malignant adnexal lesions. The kappa coefficient was 0.906, indicating almost perfect agreement between MRI and histological results. Conclusion: MRI is an accurate method for evaluating the malignancy of adnexal lesions.

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confidence: 84%

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confidence: 57%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Magnetic resonance evaluation of adnexal masses

2008

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“…MRI plays an important role in the diagnosis of gynaecological adnexial lesions [1][2][3][4]. It provides useful information for the characterisation of various ovarian, uterine and tubal masses.…”

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confidence: 99%

Diffusion-weighted imaging of solid or predominantly solid gynaecological adnexial masses: is it useful in the differential diagnosis?

Bakir¹,

Bakan²,

Tunacı³

et al. 2011

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Objectives: This study investigated whether diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values provide specific information that allows the diagnosis of solid or predominantly solid gynaecological adnexial lesions, especially whether they can discriminate benign and malignant lesions. Methods: DWI was performed in 37 patients with histologically proven solid or predominantly solid adnexial lesions (22 malignant and 15 benign neoplasms). The lesions in our data set were divided into two groups, all adnexial lesions or lesions of ovarian origin, for evaluation. The areas of the highest signal intensity on DWI (b5800 s mm 22) and the lowest ADC values within the lesions were evaluated. Results: On DWI, high signal intensity was observed more often in malignant than in benign lesions (p,0.0001). There was no significant difference between the ADC values of the malignant and benign lesions in either the adnexial (0.88¡0.16 vs 0.84¡0.42; p50.96) or the ovarian (0.85¡0.14 vs 1.05¡0.2; p50.133) lesions. When signal intensities on DWI were compared, however, malignant lesions had higher values than the benign lesions in both the adnexial (0.69¡0.21 vs 0.29¡0.13; p,0.0001) and the ovarian lesions (0.75¡0.14 vs 0.37¡0.24; p50.003). Conclusion: On DWI, high signal intensity was observed more frequently with the malignant lesions.

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